Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2020
Review[Targeted Early Detection and Prevention of Hereditary Colorectal Carcinomas].
Every year, about 60 000 people in Germany contract colo-rectal carcinoma. Hereditary factors are the cause in approx. 5 % and those affected often fall ill at a young age. ⋯ The identification of persons at risk enables a targeted early detection and prevention of cancer as an important interdisciplinary medical task. The current AWMF guideline "Colorectal carcinoma" makes concrete statements in this regard.
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Dtsch. Med. Wochenschr. · Sep 2020
Review[Acute and chronic diarrhea: a roadmap to differential diagnosis and therapy].
Diarrhea is among the most frequently reported symptoms in clinical practice. Acute diarrhea is usually caused by infectious agents with a self-limited disease course. In contrast, differential diagnosis of chronic diarrhea may be challenging. The aim of this review is to provide the reader with an overview on the causes, pathomechanisms, differential diagnosis and clinical management of acute and chronic diarrhea in adults.
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We report the case of a 27-year-old Syrian patient who came to the emergency department with a syncopal episode. No medical history could be raised due to a language barrier and so the clinical presentation was leading. ⋯ Obscure clinical symptoms alongside signs of shock, should always considered to be an allergic reaction in absence of sepsis or hemorrhage. In anaphylaxis, echinococcosis should always be included in the differential diagnosis.
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Sarcopenia is characterized by a generalized loss of muscle function, strength and mass and is codable in Germany since 2018 in the ICD-10-GM (M62.50). For screening in primary care, it is possible to determine muscle function and strength by means of a sarcopenia questionnaire (SARC-F) as a self-filler with 5 questions of restrictions. With an increased score of 4 and higher, an examination of the musculature and a determination of the skeletal muscle mass index should be performed via dual energy X-ray absorption measurement (DXA) or bioelectric impedance analysis (BIA). ⋯ The severity of the disease is defined by additional examinations such as gait speed, timed up and go test (TUG) and/or short physical performance battery (SPPB). Patients with sarcopenia suffer from increasing immobility and disability and have an increased risk of falls, fractures and mortality. Frequently, co-morbidities should be clarified in all affected patients.
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Dtsch. Med. Wochenschr. · Sep 2020
[Pharmaceutical Treatment Options in Heart Failure with Preserved Ejection Fraction].
Heart Failure causes an enormous individual and societal burden of disease with severe symptoms, a reduction in activities of daily life, frequent hospitalizations and poor prognosis. The field of heart failure with reduced ejection fraction has seen substantial innovation in the past years. ⋯ Today we have only symptoms and risk factors-based therapeutic options, and include basically diuretics, RAAsi, and antidiabetics, respectively. A causal therapy is still missing.